Explanation of Fetal Positions; What Poses Are Beneficial and What Poses Should Be Avoided During Pregnancy

21 Apr Explanation of Fetal Positions; What Poses Are Beneficial and What Poses Should Be Avoided During Pregnancy

The cervix is opened by the babyÂs head pushing against it with each contraction. You can visualize this action by picturing the cervix as a turtle neck sweater through which the head is slowly emerging. Ideally, to push the cervix open most effectively, the babyÂs chin is flexed, and the smallest part of the babyÂs head (the occiput) presents first. However, sometimes the babyÂs occiput is facing backwards or is posterior, so it does not emerge first.
Posterior Position

The baby presenting in a posterior position can lead to a host of issues. For one, dilation and progression usually take longer, and some women get ÂstuckÂ at a certain point in dilation. The mother may experience intense back pain, since the babyÂs skull is pressed up against her sacrum. She may also experience the urge to urinate during each contraction, because the babyÂs forehead is pushed up against her bladder.

At times it is it difficult to rotate a baby out of the posterior position, especially if the baby has entangled itself in the cord. There are yoga poses that are encouraged and discouraged during the last trimester to help the baby move into the ideal birthing position.

Specific yoga poses to omit from the 3rd trimester practice are:

Â Legs up the wall
Â Supta Baddha Konasana (at the end of class)
Â Supported bridge for a long period of time

It is advisable to do any Âbelly downÂ pose like childÂs pose, cat/cow, body circles and a brief downward facing dog. (Please exclude downward dog if the baby was once in a breech position and has finally turned head down.) I also encourage women to sit on a birth (exercise) ball or sit upright or leaning forward in chairs. If the mother has access to a pool, swimming is a fantastic activity for the last trimester since the mother is belly down for a prolonged period of time, and immersing the body in water can help reduce swelling.

During the last trimester I encourage the mothers to spend as little time on their backs as they can. This includes asking them to check in with the way they recline at home as well as in the yoga studio. It is so easy (and desirable!) to come home and drop back into the couch or comfy chair. They should avoid doing so, however, since it creates a hammock-like shape for the back and invites the baby to settle into a spine-to-back position.

Another reason that the baby may present posteriorly is that the motherÂs uterine ligaments and pelvic floor muscles are tight and somewhat twisted, preventing her baby from settling into a good position. Luckily, many poses we do in prenatal yoga encourage the pelvic and uterine ligaments to gently open and relax. Exercises that relax and tone the pelvic floor muscles are also included in class.

If the baby is malpositioned and the mother is aware of what side the baby is laying on, she can help correct this by arranging her body to encourage the baby to shift during savasana or while asleep. If the baby is OP, the mother should use Âpure side lyingÂ as opposed to semi-prone. The mother should lie on the side towards which the occiput is already facing, with the babyÂs back toward the bed.
If the mother would prefer to rest in a semi-prone position, she needs to lie on the side in which the babyÂs occiput and back are facing towards the ceiling. For example, if the baby is ROP, the mother would be on her left side in a semi-prone position and on her right side for Âpure side lyingÂ.

Another issue some mothers face is the baby being in a breech position. This could mean the baby is standing straight up in the womb (footling breech), presenting butt first (frank breech), sitting cross- legged in the womb (complete breech) or the baby is kneeling inside (kneeling breech). Either way, very few doctors will deliver a breech baby vaginally. If a mother finds out her baby is breech, she is often anxious to help turn the baby around. Luckily, there are some yoga poses that can assist with this.

Beyond these specific yoga poses, acupuncture has been known to help. Also, you can try placing ice at the fundus since the baby will likely move away from the cold. Or, place music or light down at the pelvic opening since babies will go toward sound and light.

In general, mothers should be mindful of the babyÂs position as she nears her due date and tailor her practice accordingly. Yoga can have a powerful effect on these last few weeks and days of pregnancy!

Related Posts:

28 Comments

Lauren

I am wondering if/when/how a baby is determined to be in a posterior position. I was told by my OB that OP is discovered once you are dilated to 4-5 cms, not before, and thus this provides little time to try and move the baby into a better position. Is this true? I seem to recall that women at the yoga studio knew they were posterior. How did they know? Did they have a late ultrasound I didn’t have?

I am a little surprised to hear that your doctor can not determine a posterior baby until 4-5cm. A typical back labor will present itself as intense back aches, strong frequent contractions, signs of labor progressing further then it actually is, and the urge to urinate during the contraction. When I have encountered this with clients, we go in expecting to hear that the mom is pretty far along since her contractions are close together and strong and get informed that she may only be 1-2cm. That is a tell tale sign that the baby is most likely in a posterior position.

Another way to figure out where your baby is in your body is “belly mapping.” (check out spinningbabies,com for further details). This method helps you figure out your baby’s position by paying attention to where you are feeling the kicks and the bulges and firm spots. You can also look at your belly and if there is a depression under the belly buttom, that could possibly indicate that the baby’s spine is towards your back and it’s head and feet are facing outward.

Another way for your care provider to identify your baby’s position is to palpate your belly. Last summer when I attended a week long program at The Farm Midwifery Center, the midwives taught us a technique called the “Leopold’s maneuver”. This is a technique of feeling the belly and identifying the hard bulge (head), less firm bulge (butt) and the firm, convex, smooth. resistant mass (the baby’s back).

One final way a care provider can asses how the baby is positioned is by using an ultra sound. This is something in the last several years I have seen used upon arrival in triage. I am guessing they want to make sure the baby is not in a breech position.

Babies do however move and rotate during labor. So do not feel totally discouraged should your baby be “sunny side up”.

Deb Flashenberg

It is advised to avoid lying on your belly during pregnancy because it is too much pressure and weight on your uterus and growing baby.

As for your question about backbends and deep twists, some schools of yoga teach cobra and upward facing dogs with support under the pelvis. At the Prenatal Yoga Center, we omit those poses because we believe it is not safe to stretch the belly that deeply. If the rectus abdominis muscles (the 6 pack muscles) are stretched too much it can lead to a separation of this muscle group called diastasis. While it is normal to have some separation of the rectus abdominis muscles during pregnancy, more extreme diastasis can be prevented by avoiding backbend and deep twists.

We do include gentle backbends since the chest opening is so beneficial for the pregnant body. However, we avoid deep backbends because the pregnant belly pulls the body forward and the mother is extending strongly to counteract this pull, the back muscles can get overworked, strained and tightened and the vertebrae can get compressed. So instead of adding to the already over-flexed pregnant back, it would be more beneficial to to try strengthen these muscles and balance out the overuse in certain areas with safe extension, gentle flexion, side-bending and gentel twisting.

As I had said, many places and practitioners continue to keep these poses in their practice and the poses may feel good for the individual. At the PYC, we try to teach poses that we feel will aid in the comfort and give strength and stability to the pregnant body.

Hope that helps!

Keep practicing!

Take care,

Deb

Margot

marie-pierre julien

I’m 33 weeks pregnant and my baby is breech. I practice yoga very regulary and concentrate on the poses that could help turn the baby.Meanwhile,I would like to consult a doctor specialized in acupuncture . Do you have anyone you know to recommend ?
Also I attend the prenatal yoga one Saturday and the teacher mentionned a doctor nearby the upper west side studio who is an expert in turning babies.

I am so glad that you are doing poses that concentrate on turning your baby. Many women have had success turning their baby this way.

As for seeing an acupuncturist, I have been working with Frances Goodwin, LAc for about 7 years. She is extremely knowledgeable and patient. However, she is not on the UWS, she is down in Union Square. Her phone number is 212 414 0388.

Take care,

Deb

Priya

I am trying to find out if I can do baddakonasana and trikonasana during the very first weeks of conception. Would really appreciate your reply as I am confused when some say you can and some say you cant.

The best advise is to listen to your body during pregnancy. That said, there are several poses I don’t recommend doing during pregnancy, deep backbends, arm balances, most inversions, deep twists and stomach down poses.

We regularly do baddakonasana and trikonasana in class. I feel they are completely safe. You can always modify these poses so that you don’t work too deeply if you are feeling strained in the asana.

Hope that sheds so light on what to do and what to avoid. Keep practicing!

Deb

At 31 weeks, I would not be too concerned about a breech baby. If your baby is still by week 34 or 35, you can start trying to turn your baby around.

To answer your questions, you are fine in “butt up child’s pose” since gravity is helping to turn your baby. That is actually one of the best positions to be in to help turn your child. Don’t worry that it is opening your pelvis.

I would also put a cold pack at the top of your belly and light and music at the bottom. Acupuncture can also be helpful to turn your little one. As for body positions, it is recommended to invert your hips for abut 15-20 minutes several times a day. Abdomen strengtheners or cat/cow will not really have an effect on rotating your baby.

Hope this helps!! 🙂

Take care,
Deb

Daisy

I am 30 weeks pregnant with my first child and hoping to have a natural childbirth. I have been practicing yoga for three years. While I am pregnant, I have been doing mainly pre-natal yoga (some beginner level hatha and flows classes too) and swimming.

I am now in my third trimester and I know from my last ultrasound that the baby has turned head-down. I wonder if I can still continue with my downward facing dogs. I asked one of my pre-natal instructor but she wasn’t sure. She finally suggested that I do not stay in a downward facing dog for long. But in my flow classes, the instructor would sometimes hold downward facing dog for as long as three minutes. Yesterday after a three minute downward facing dog, my little girl kicked actively during the pose and remained very active after the class. I worried she was trying to turn!

Just wondering what you think of this. Does the time held in a pose matter or should I avoid inversion pose completely?

I tend to take a bit of a more conservative approach when it comes to inversions. In prenatal yoga, at the Prenatal Yoga Center, we do not include headstand, handstand, shoulder stand or forearm stand in class. Our inversions are downward dog, uttanasana, prasrita padatonasana and legs up the wall with support under the pelvis.

If you are going to do downward facing dog in your third trimester, I would suggest limiting the time to 3-8 breathes. I think 3 minutes is not a great idea if you already have the baby head down. For moms with a breech baby, I usually suggest downdog or any pose with the butt in the air for 3-10 minutes to help encourage the baby to rotate into a more optimal “head down” birthing position.

Hope this helped a bit! 🙂

Take care
Deb

Nene

I have just been to see my doctor and informed that my baby is breech. This saddened me and my partner as we are first time parents. My lower back aches all the time,my fet swell and i cannot seen to handle the pain any longer.

Can you kinldy recomments any kind of excercises. or even breathing ones.

Nene

Hi.. I’m 31 weeks pregnant and just foung out my baby is breech. Can you recomment any exercise that my partner and i can use to ease the pack pains and the tension as well. Where do i start looking for assistance for this… Can you recommend anyone?

Beyond these specific yoga poses, acupuncture has been known to help. Also, you can try placing ice at the fundus since the baby will likely move away from the cold. Or, place music or light down at the pelvic opening since babies will go toward sound and light.

Also- you may consider doing counterpressure on the lower back or using a hot water bottle to relieve your lower back pain.

You may also consider a prenatal massage. I like Laurie Dawson at 212 864 8641 or Anne Heckheimer at the Prenatal Massage Center at (917) 359-8176.

Good luck!!

Deb

Debra

I’m 38 weeks and my 4th baby has been breech since at least 35 weeks. I’ve tried acupuncture, moxabustion, even an external version two days ago at the hospital. My first three were wonderful vaginal deliveries and I’m just devastated at the thought of a C-section in 12 days. I plan to go swimming tonight because my friend, a yoga instructor, said doing somersaults in the water may help.

ANything you can suggest at this point or am I too far along?

My OB was surprised the version didn’t work bc baby’s butt isn’t that far down, I have lots of amniotic fluid, it’s my fourth baby and the baby is small.

tina

Â Legs up the wall
Â Supta Baddha Konasana (at the end of class)
Â Supported bridge for a long period of time

I guess the 1st and 3rd points are only for bbs who are engaged. But, why omit supta baddha konasana at the end of the class? Is it okay then to do it the beginning or mid way through the class? ‘cos I thought this is a good pose to opent he hips?

Thank you so much for your comment and question! The reason we omit supta baddha at the end of class is because we do not want the baby to move into a posterior position while the mother is reclined on her back. The reclined position since creates a hammock-like shape for the back and invites the baby to settle into a spine-to-back position. This can lead to an OP (occiput posterior) position. Not ideal for labor.

We do supta baddha at the beginning of class since we know the moms will soon be moving around and in an “all 4’s” position.

Dear Deb
Thank you for, as usual, a very interesting post. I’m a Prenatal Yoga instructor and I have a lady who is 29 weeks pregnant with placenta previa. Do you think the inverted poses that help to turn a breech baby can also be useful in her case, ie. to help the pacenta to rise? Or should she only do restorative poses? Btw, I’ve read your previsous post about placenta previa and avoiding the pelvic opening poses, which is a very sensible advice. Thank you.

Thank you for taking time to read the blog! The placenta’s position is not be effected by the mother’s position; reclining, inverted or upright. The placenta is adhered to the uterine wall, it doesn’t actually move on it’s own. As the uterus grows, the placenta will hopefully shift off the cervix.

Jennifer

I am 32 weeks pregnant. At my last Dr. apt (about 3 weeks ago), I mentioned that it felt like this baby (2nd pregnancy) was really low, with alot of pelvic pressure already. Sure enough this kiddo is already ‘engaged’ and head down. The doctor was concerned about possible cervical shortening (and potential for early dilation). None was detected but he wanted me to take it easy and cut back on walking and exercise. Been taking it really easy last few weeks but am starting to get SO uncomfortable from not stretching and doing my yoga! Do you have any recommendations for what easy poses and stretching should still be safe? Or any specific moves I should stay away from for a few more weeks that might further engage the baby? Yoga was perfect natural childbirth/labor preparation last pregnancy and I don’t want to miss that this time around.

If your doctor is concerned about putting pressure on your cervix causing dilation, I would recommend staying away from standing poses and deep hip openers like baddha konasana. Instead, you can still focus on upper body poses that you can do seated, like garudasana arms or gomukhasana arms. You can also do seated cat/cow or on all 4’s cat/cow, body circles on hands and knees, downward dog, supported bridge pose, gentle twists and side stretches. All these poses can still give your body some relief from the stiffness you are feeling and get your circulation moving. Which will make you feel better.

Hope this helps! And best of luck on your upcoming birth. Welcome to your second journey into motherhood!